Provider Demographics
NPI:1407868227
Name:O'TOOLE, CELLER Y (PT)
Entity Type:Individual
Prefix:MS
First Name:CELLER
Middle Name:Y
Last Name:O'TOOLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SHOU-HUNG
Other - Middle Name:CELLER
Other - Last Name:YING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:140 HOLDER RD NE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:OH
Mailing Address - Zip Code:43105-9710
Mailing Address - Country:US
Mailing Address - Phone:614-578-8706
Mailing Address - Fax:614-839-9206
Practice Address - Street 1:2862 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3700
Practice Address - Country:US
Practice Address - Phone:614-868-6952
Practice Address - Fax:614-839-9206
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist